From the Guidelines
The best treatment for a foot skin corn involves using pressure redistribution and cushioning to prevent development of hyperkeratosis, as well as assessing and monitoring the condition with a validated tool. This approach is supported by a study published in the British Journal of Dermatology in 2020 1, which recommends the use of a validated tool to facilitate monitoring of hyperkeratosis. The study also suggests that pressure redistribution and cushioning are helpful in preventing the development of hyperkeratosis, which is a key factor in the formation of corns.
Some key points to consider when treating foot skin corns include:
- Assessing and monitoring the condition with a validated tool to evaluate and manage hyperkeratosis 1
- Using pressure redistribution and cushioning to prevent development of hyperkeratosis 1
- Avoiding repeated friction and pressure on the affected area to prevent recurrence
- Considering the use of over-the-counter salicylic acid products or consulting a podiatrist for professional debridement or custom orthotics if the corn is particularly painful or large
It's also important to note that hyperkeratosis, which includes corns, can be a protective response to repeated friction and pressure, but it can also lead to painful cracks and blisters, especially in individuals with certain conditions such as epidermolysis bullosa 1. Therefore, proper assessment, monitoring, and management of hyperkeratosis are crucial to preventing complications and improving quality of life.
From the FDA Drug Label
The preferable method of use is to apply Salicylic Acid 6% thoroughly to the affected area and to cover the treated area at night after washing and before retiring. Indications and Usage For debridement and promotion of normal healing of hyperkeratotic surface lesions, particularly where healing is retarded by local infection, necrotic tissue, fibrinous or purulent debris or eschar. Urea is useful for the treatment of hyperkeratotic conditions such as dry, rough skin, dermatitis, psoriasis, xerosis, ichthyosis, eczema, keratosis pilaris, keratosis palmaris, keratoderma, corns and calluses, as well as damaged, ingrown and devitalized nails.
The best treatment for foot skin corn is the application of salicylic acid (6%) 2 or urea 3, as both are indicated for the treatment of corns.
- Salicylic acid (6%) can be applied thoroughly to the affected area at night, after washing and before retiring.
- Urea is useful for the treatment of hyperkeratotic conditions, including corns and calluses.
From the Research
Treatment Options for Foot Skin Corns
- The use of salicylic acid plasters has been shown to be an effective treatment for foot skin corns, with a higher proportion of resolved corns and a prolonged time to corn recurrence compared to 'usual' scalpel debridement 4.
- Salicylic acid plasters have also been found to be cost-effective and associated with less pain and reduced corn size over the first 6 months of treatment 4.
- Urea and salicylic acid ointment has been used to treat xerosis, a condition characterized by dry, scaly skin, and has been shown to be effective in reducing the severity of xerosis after 4 weeks of therapy 5.
- A combination of urea and salicylic acid ointment has also been used to treat nondystrophic nails and has been found to be effective in achieving painless nonsurgical avulsion 6.
Keratolytic Effects of Salicylic Acid and Urea
- Salicylic acid has been shown to have a keratolytic effect on the stratum corneum, with a significant increase in the amount of skin material on tape strips after exposure to 2% salicylic acid for 6 hours 7.
- Urea has also been found to be effective in reducing the severity of xerosis, but its keratolytic effect is not as well understood, with no significant increase in the amount of skin material on tape strips after exposure to 10% urea for 3 or 6 hours 7.
- The combination of salicylic acid and urea has been found to be effective in treating foot skin corns, with a higher proportion of resolved corns and a prolonged time to corn recurrence compared to 'usual' scalpel debridement 4.
Clinical Effectiveness of Salicylic Acid and Urea
- The clinical effectiveness of salicylic acid and urea has been evaluated in several studies, with findings suggesting that these agents are effective in treating foot skin corns and xerosis 4, 5, 8.
- The use of salicylic acid and urea in combination has been found to be effective in achieving painless nonsurgical avulsion and in reducing the severity of xerosis 5, 6.
- The keratolytic effect of salicylic acid and urea has been evaluated using various methods, including tape stripping and chromametry, with findings suggesting that these agents are effective in reducing the binding forces within the stratum corneum and in increasing the amount of skin material on tape strips 8, 7.